The Changes Of Coagulation And Fibrinolytic System In Patients With Hyperglycaemia And Metabolic Syndrome And The Effect Of Rosiglitazone

Objective:To observe whether there is abnormal function of coagulation and fibrinolytic in metabolic syndrome patients, who are suffering from hypertension, diabetes mellitus or higher fasting blood glucose, abdominal obesity all at once. And to speculate the mechanism of coagulation and fibrinolysis after rosiglitazone treatment by measuring several indicators.Methods:50 cases of metabolic syndrome outpatients were enrolled into MS group and 20 normal healthy individuls enrolled into normal group. The 50 of MS patients were divided into two groups through the method of random. One was experimental group of MS, the other is control group of MS and each group had 25 patients of MS. The 25 of MS patients in the control group accepted conventional treatment, those were lowering blood pressure, lowering blood sugar, regulation of blood lipids. The 25 of the experimental group of MS patients accepted not only conventional treatments, but also rosiglitazone. The subjects in normal group accepted no treatment. All the MS patients were treated and observed for 12 weeks. The concentrations of adiponectine, plasminogen activator inhibitor-1, fibrinogen of all subjects were measured before and after treatment by method of Enzyme-linked immunosorbent assay. We observed the variety of indicators and make the correlation and regression analysis of data.Results: 1.Compared to the levels in normal group, the levels of adiponectin, fibrinogen, PAI-1 and HOMA-IR were statistically different in MS group. The level of adiponectin was lower, but other indicators were higher in MS group than normal group.2. In MS patients, fibrinogen level had positive correlation with age, SBP, DBP, LDL-C, HOMA-IR, PAI-1, and negative correlation with adiponectin level; PAI-1 constration was relevant to the level of SBP, FBS, LDL-C, HOMA-IR and adiponectin3. After treatment of 12 weeks, there were differences of levels of ALT, adiponectin and fibrinogen between two groups(P<0.05)4. Compared to control group of MS, levels ofâ–³ADPN,â–³PAI-1,â–³Fg,â–³HOMA-IR were statistically different and changes of those indicator levels were obvious in experimental group of MS.5. In experimental group of MS,â–³PAI-1 was positively associated withâ–³ADPN andâ–³HOMA-IR, andâ–³Fg was also positively associated withâ–³ADPN andâ–³HOMA-IR. Multiple liner regression analysis showed thatâ–³PAI-1 was significantly and positively associated withâ–³ADPN andâ–³HOMA-IR, the equation was Y=0.436+0.114X1+0.618X2, but this trail did not see the association betweenâ–³Fg andâ–³ADPN,â–³HOMA-IR in regression analysis.Conclusions:1. Patients with hyperglycaemia and metabolic syndrome had abnormal status of hypoadiponectin and coagulation hyperthyroidism. 2. Rosiglitazone can reducing the levels of fibrinogen and PAI-1, and improve the function of coagulation and fibrinolytic system.3. Rosiglitazone improved fibrinolysis function perhaps by improving insulin resistence and elevating adiponectin level.Adiponectin probably play a key role in the unbalance of coagulation and fibrinolysis function.